Motivational Reserve: A Moderator of Apathy and Depression in A US-representative Sample

Motivational Reserve (MR; Forstmeier and Maercker, 2008), a complementary process to Cognitive Reserve (CR), is proposed to attenuate cognitive impairment in later life. Particularly, high MR is proposed to be associated with prolonged maintenance of cognitive function, delayed Alzheimer’s disease (AD) onset, and subsequently a more rapid illness progression. Pre-morbid motivational abilities constituting MR, and the presence of neuropsychiatric symptoms of apathy and depression, have, independently, been associated with increased conversion rates from Mild Cognitive Impairment (MCI) to AD. Until this study, the moderating effects of pre-morbid motivational abilities on apathy and depression progression in dementia have not been established. Using the Aging, Demographics, and Memory Study subsample of the USrepresentative Health and Retirement Study, a longitudinal cohort comparison (N=80) of motivational abilities on apathy and depression progression was conducted. Participants were 70 years or older and categorized into normal, MCI and AD cohorts. MR was estimated using detailed occupational history (utilizing the Occupational Information Network (O*NET) database). Baseline and follow-up assessments were conducted 2 years apart. Using the Neuropsychiatric Inventory, Analysis of Variance and Covariance were conducted to determine the protective role of MR on apathy and depression within the cohorts. Analyses demonstrated significant cohort differences for MR when controlling for CR (p=.037), for apathy (p=.004) and depression (p=.001). Analyses including the covariables of MR, CR, and baseline apathy and depression further demonstrated significant differences. These findings suggest that over and above educational attainment, this index of MR has a protective function for apathy and depression in cognitive impairment.